Turnbull J M, Buck C
Arch Intern Med. 1987 Jun;147(6):1101-5.
To assess the value of routine screening preoperative investigations in an otherwise healthy surgical population, the charts of 2570 patients undergoing cholecystectomy in two university teaching hospitals were reviewed. Of these, 1010 patients who were believed to be free of active disease other than cholelithiasis were selected for further study. Preoperative screening investigations were assessed in terms of frequency of use and abnormalities detected. The predictive values of these tests were analyzed and compared with information obtained from the history and physical examination. The frequency with which action was taken because of abnormal test results was also determined. Of the 5003 preoperative screening tests performed, abnormal results were obtained in 225. Of these, 104 were of potential importance. Action resulting from these abnormalities occurred in 17 cases. In only four patients could a conceivable benefit have arisen from a preoperative screening test. When compared with the results of the history and physical examination, routine preoperative investigations provided little further information that altered management in otherwise healthy surgical patients undergoing cholecystectomy.
为评估常规术前筛查检查在其他方面健康的手术人群中的价值，我们回顾了两所大学教学医院中2570例接受胆囊切除术患者的病历。其中，1010例被认为除胆石症外无其他活动性疾病的患者被选入进一步研究。术前筛查检查从使用频率和检测到的异常情况方面进行评估。分析了这些检查的预测价值，并与从病史和体格检查中获得的信息进行比较。还确定了因检查结果异常而采取行动的频率。在进行的5003项术前筛查检查中，225项结果异常。其中，104项具有潜在重要性。因这些异常而采取行动的有17例。在仅4例患者中，术前筛查检查可能带来了可想象的益处。与病史和体格检查结果相比，常规术前检查几乎没有提供更多能改变接受胆囊切除术的其他方面健康的手术患者管理方式的信息。
